R 061543Z OCT 09

ALCOAST 582/09
COMDTNOTE 6010
SUBJ: 2009 NOVEL INFLUENZA A (H1N1) VACCINE IMMUNIZATION PROGRAM
A. IMMUNIZATIONS AND CHEMOPROPHYLAXIS, COMDTINST M6230.4 (SERIES)
B. MEDICAL MANUAL, COMDTINST 6000.1 (SERIES)
1. NOVEL INFLUENZA A (H1N1) WAS FIRST RECOGNIZED IN APRIL 2009.
SINCE THAT TIME IT HAS SPREAD GLOBALLY WITH THE WORLD HEALTH
ORGANIZATION (WHO) DECLARING A PANDEMIC ON 11 JUNE 2009.
2. THE MOST IMPORTANT COUNTERMEASURE TO PROTECT AGAINST AN
INFLUENZA VIRUS IS VACCINATION.
3. ADDITIONALLY, TAKING SIMPLE DAILY PRECAUTIONS CAN HELP PREVENT
THE TRANSMISSION OF BOTH SEASONAL INFLUENZA AND NOVEL INFLUENZA A
(H1N1).
 A. COVER COUGHS AND SNEEZES WITH A TISSUE AND THROW THE TISSUE
AWAY
 B. PRACTICE GOOD HYGIENE BY WASHING YOUR HANDS OFTEN AND USING
ALCOHOL BASED HAND SANITIZER
 C. USE APPROPRIATE DISINFECTANTS TO CLEAN YOUR WORK AREA.
FOR MORE INFORMATION ON NOVEL INFLUENZA A (H1N1) AND PREVENTIVE
MEASURES GO TO THE CDC WEBSITE AT HTTP://WWW.CDC.GOV/H1N1FLU.
4. THE DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) ANTICIPATES
THAT THE 2009 H1N1 VACCINE WILL BE AVAILABLE IN MID-OCTOBER.
5. NOVEL INFLUENZA A (H1N1) VACCINATION IS MANDATORY FOR ALL COAST
GUARD (CG) ACTIVE DUTY (AD) AND SELECTED RESERVE PERSONNEL
(SELRES).
6. AD AND SELRES MEMBERS SHALL ACHIEVE 100 PERCENT COMPLIANCE WITH
THE NOVEL INFLUENZA (H1N1) VACCINE NLT 1 DEC 2009.
7. REQUESTS FOR ADMINISTRATIVE AND MEDICAL EXEMPTIONS SHALL BE
PROCESSED IN ACCORDANCE WITH REF A.
8. COMMANDING OFFICERS ARE RESPONSIBLE FOR ENSURING PERSONNEL
IMMUNIZATION READINESS, INCLUDING ENSURING THEIR PERSONNEL RECEIVE
BOTH THE SEASONAL INFLUENZA VACCINE AND THE NOVEL INFLUENZA A
(H1N1) VACCINE. COMMANDING OFFICERS CAN TRACK INDIVIDUAL AND UNIT
COMPLIANCE USING CGBI VIA HTTP://CGCENTRAL.USCG.MIL.
9. CG CLINICS ARE NOT EXPECTED TO PURCHASE H1N1 VACCINE. HOWEVER,
CLINICS SHOULD PROCURE SUFFICIENT ANCILLARY SUPPLIES TO ADMINISTER
THE NOVEL INFLUENZA A (H1N1) VACCINE TO MEMBERS IN THEIR AREA OF
RESPONSIBILITY (AOR).
 A. FOR AD AND SELRES MEMBERS AND CIVILIAN EMPLOYEES, THE VACCINE
WILL BE DISTRIBUTED TO THE CLINICS VIA THE DEFENSE SUPPLY CENTER
PHILADELPHIA (DSCP).  IF A MEDICAL OFFICER (AS DEFINED BY REF B) IS
PRESENT, CIVILIAN EMPLOYEES MAY RECEIVE VACCINATION AT A CG CLINIC
OR AT A CG SICKBAY.
 B. FOR NON-MILITARY TRICARE BENEFICIARIES, CLINICS MAY REGISTER
THROUGH THEIR RESPECTIVE STATES AS A VACCINE PROVIDER AND OBTAIN
NOVEL INFLUENZA A (H1N1) VACCINE TO VACCINATE ELIGIBLE DEPENDENTS
AND RETIREES WHO MEET THE ADVISORY COMMITTEE ON IMMUNIZATION
PRACTICES (ACIP) TARGET GROUPS (ON A SPACE AVAILABLE BASIS). STATE
CONTACT INFORMATION CAN BE FOUND AT
HTTP://WWW.CDC.GOV/H1N1FLU/VACCINATION/STATECONTACTS.HTM.  NON-
MILITARY BENEFICIARIES CANNOT RECEIVE VACCINATIONS AT A CG SICKBAY.
10. CG AD AND SELRES MEMBERS WHO RECEIVE CARE AT DOD MILITARY
TREATMENT FACILITIES CAN OBTAIN THE VACCINE FROM THEIR PRIMARY CARE
MANAGER (PCM).
11. CG AD AND SELRES MEMBERS WHO RECEIVE CARE WITH CIVILIAN TRICARE
PROVIDERS SHOULD CONTACT THEIR CIVILIAN PCM TO DETERMINE IF AND
WHERE THEY CAN RECEIVE THE VACCINE. IF THEY ARE UNABLE TO OBTAIN
THE VACCINE, THE MEMBER SHOULD CONTACT THEIR COGNIZANT HEALTH,
SAFETY AND WORK-LIFE SUPPORT ACTIVITY (HSWL SUPACT) FIELD OFFICE
FOR FURTHER GUIDANCE.
12. CONTRACTORS SHOULD ENGAGE WITH THEIR CONTRACTING OFFICERS
TECHNICAL REPRESENTATIVE TO DETERMINE HOW TO RECEIVE THE VACCINE.
13. THERE ARE INTRANASAL AND INJECTABLE VACCINES. FOR MILITARY
MEMBERS, ONLY THE INJECTABLE VACCINE WILL BE AVAILABLE. THE
INJECTABLE VACCINE WILL BE ADMINISTERED INTRAMUSCULARLY, OVER THE
DELTOID MUSCLE AS A SINGLE DOSE.
14. VACCINE WILL BE DELIVERED IN STAGES, NECESSITATING
PRIORITIZATION OF VACCINE RECIPIENTS. IN THE INITIAL DELIVERY
STAGES, VACCINE WILL BE TARGETED TOWARD THE FOLLOWING AD, SELRES
AND CIVILIAN PERSONNEL:
 A. DEPLOYING AND DEPLOYED PERSONNEL
 B. TRAINING CENTERS (INCLUDING THE COAST GUARD ACADEMY)
 C. HEALTH CARE PROVIDERS AND EMERGENCY MEDICAL SERVICES PERSONNEL
 D. PREGNANT WOMEN
 E. PERSONNEL AGED 25 THROUGH 64 YEARS WHO HAVE HEALTH CONDITIONS
ASSOCIATED WITH HIGHER RISK OF MEDICAL COMPLICATIONS FROM INFLUENZA
(WWW.CDC.GOV).
 F. CIVILIAN EMPLOYEES WORKING AT CG CHILDCARE DEVELOPMENT CENTERS
15. ONCE THE FULL COMPLEMENT OF VACCINE IS RECEIVED, THE REMAINDER
OF AD, SELRES AND CIVILIAN EMPLOYEES NOT IDENTIFIED IN PARAGRAPH 14
MAY BE VACCINATED.
16. ALL VACCINES FOR MILITARY MEMBERS MUST BE DOCUMENTED IN THE
MEDICAL READINESS REPORTING SYSTEM (MRRS). IN MRRS, THERE ARE 4 CVX
CODES FOR THIS VACCINE: 125 LIVE INTRANASAL, 126 INJECTABLE
PRESERVATIVE FREE, 127 INJECTABLE, AND 128 UNKNOWN. CG HEALTH
SERVICES PERSONNEL SHOULD USE CVX CODE 127 FOR MILITARY MEMBERS
RECEIVING THE DSCP SUPPLIED VACCINE. FOR THE PURPOSE OF CAPTURING
WORKLOAD, PGUI ENTRIES MUST BE COMPLETED. MEMBERS WHO RECEIVE
VACCINATIONS FROM NON-CG FACILITIES WILL PROVIDE IMMUNIZATION DATA
TO THEIR APPROPRIATE HEALTH SERVICES PERSONNEL.
17. REPORT KNOWN OR SUSPECTED ADVERSE EVENTS RELATED TO THE
ADMINISTRATION OF INFLUENZA VACCINE TO THE VACCINE ADVERSE EVENT
REPORTING SYSTEM (VAERS) AT WWW.VAERS.HHS.GOV.
18. PRIOR TO ADMINISTERING THE VACCINE, HEALTH SERVICES PERSONNEL
SHOULD PROVIDE A COPY OF THE VACCINE INFORMATION STATEMENT (VIS)
AVAILABLE AT HTTP://WWW.CDC.GOV/VACCINES/PUBS/VIS/. IN THE ABSENCE
OF AN AVAILABLE VIS, HEALTH SERVICES PERSONNEL WILL SCREEN
PERSONNEL ACCORDING TO PACKAGE INSERT INFORMATION TO IDENTIFY
CONTRAINDICATIONS TO IMMUNIZATIONS.
19. FOR QUESTIONS PERTAINING TO THIS POLICY CONTACT CDR SCHWARTZ,
COMDT (CG-1121) AT (202)475-5172 OR ERICA.G.SCHWARTZ(AT)USCG.MIL.
FOR QUESTIONS REGARDING VACCINE ADMINISTRATION AND IMPLEMENTATION
CONTACT HSWL SUPACT, CAPT FAJARDO AT (510)637-1225 OR
MARIO.E.FAJARDO(AT)USCG.MIL OR CDR SALVON-HARMAN AT (757)628-4331
OR JEFFREY.C.SALVONHARMAN(AT) USCG.MIL.
20. CAPT D. CULKIN, ACTING DIRECTOR OF HEALTH, SAFETY AND WORK-LIFE
SENDS.
21. INTERNET RELEASE AUTHORIZED.